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Cough stress test outperforms 24-hour pad test for diagnosis of stress urinary incontinence

26 May 2018

Cough stress test (CST) is more accurate than the 24-hour pad test in diagnosing stress urinary incontinence, a recent study has shown.

For the randomized comparative study, researchers recruited 140 females who were assigned to undergo CST with one of four bladder conditions: a comfortably full bladder (group 1; n=34), an empty bladder (group 2; n=35), bladder infused with 200 cc saline (group 3; n=37) and bladder filled to half of its functional capacity (group 4; n=34).

CST was performed with each patient standing and sitting, the sequence of which was randomly determined for each participant.

Combining the results for the sitting and standing position, the sensitivity of CST was highest in group 4, with a value of 83 percent. Both groups 3 and 1 yielded sensitivity values of 77 percent, while group 2 had a value of 65 percent. There was no significant heterogeneity among these values (p=0.57).

Specificities were similarly high in the combined positions. Group 4 again showed the highest specificity at 90 percent, which was followed by group 2 (87 percent). Groups 3 and 1 had specificity values of 73 percent and 58 percent, respectively (p=0.30 for homogeneity).

In contrast, the 24-hour pad test was not significantly predictive of stress urinary incontinence (area under the curve, 0.60; p=0.08).

The findings of the present study “challenge the accepted dogma that one CST method significantly outperforms another,” said researchers.

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